Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keaton James Rider

Individual provider Independent Duty Medical Technicians · NPI 1083369938

Keaton James Rider is an Independent Duty Medical Technicians in Cannon AFB, New Mexico. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2022

Practice location Address checks out

104 W D.l Ingram Ave
Cannon AFB, NM 88101
Phone: (575) 784-2778
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Medical Technicians (primary) Taxonomy 1710I1003X · Licence L5ALJ4N051C00AB (TX)

Record details

NPI number1083369938
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 18, 2022
Last updated in NPPESAugust 2, 2022
Certification dateJuly 21, 2022
Mailing address6948 Campos Ave Unit B, Jber, AK 99506-3423

Other providers in Cannon AFB